Pathologizing our Survival

These days I think a lot about Psychology as a mechanism of social control. What would our world look like if we totally eliminated the idea of “mental illness” and instead understood psychological distress as problems of living as Thomas Szasz suggests in his book The Myth of Mental Illness? What if we approached problems of living as having grown out of conditions of oppression and abuse and not personal deficit?
I sense that there is something missing in these suggestions, something I can’t quite put my finger on yet. For one, the evidence ( both personal and clinical for me) that psychological distress has a component of biochemical/genetic basis is compelling. At the same time, we know that trauma impacts an individual not just psychologically but can impact the actual physiological composition of the brain. There is also the emerging study of insidious trauma- the everyday, mundane, micro-traumas of living daily oppressions that affect the emotional well being of individuals and whole populations. Throwing out the DSM-IV-TR (the weighty text that defines and codifies all mental illnesses) is not the solution (though I’m not convinced it might not be a good first step) to changing our culture that punishes psychological diversity, pathologies coping mechanisms, and stigmatizes those of us who experience extreme emotional states.

I have recently become familiar with the argument from some feminist psych scholars that what is labeled Borderline Personality Disorder (BPD) can be better understood as Complex Post Traumatic Stress Disorder. In reviewing literature regarding BPD and Bulimia Nervosa (BN), both diagnoses that are overwhelmingly assigned to women, I found that 60-80% of BPD patients have experienced childhood abuse, mostly sexual, and 60% of BN patients have survived sexual violence. Post Traumatic Stress Disorder has long been the darling diagnosis of feminists because it is one of the few disorders that can be attributed solely to situational causes, thus making it “non-blaming.” I think we need to dig deeper than that to define mental health as a feminist issue, push the field of psychology to advocate for social change and not just for band aids for the majority of us who have been damaged by this society, and to recognize the multitude of ways that consent and autonomy are often what are at stake in the arena of defining and treating “mental illness.”

Hello, I found this site via the book announcement on Feministing. And I wanted to say thank you for this post (and quite a few others, too!) My counselor recently asked me to reconsider calling myself “needy”–which was me judging myself while in a bad state–and instead reframe what was going on as a coping mechanism that may have been useful at one point but is no longer useful now. And she reminded me to not make these sorts of judgments and to be gentle with myself, which in the short time I’ve done counseling has been wonderfully useful. All this to say there are mental health practitioners out there who aren’t pathologizing and shaming! 🙂

I think you’re right on about coping mechanisms that were once useful but may not be the adaptive in the current moment. One of the most important skills to learn as people who struggle with mental health stuff is not to beat ourselves up about the ways we’ve found to survive. The disableist culture we live in beats us up enough. Accusation of “craziness” and “insanity” have too long been waged against survivors to discredit their experiences, against women to disempower their resistance to oppression, and casually in our larger culture as catch all words that trivialize mental health struggles and erase the ways that these words and concepts have been used as weapons of abuse.